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Unpacking CMS’s Final Rules on Medicaid Access and Managed Care

NCQA

The Centers for Medicare & Medicaid Services (CMS) recently announced two major updates to Medicaid regulations. This blog will delve into their significance and key policy implications for states and managed care organizations (MCO). Ensure Payment Adequacy for HCBS Direct Care Workers.

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How We Help Medicaid & Long-Term Services and Supports

NCQA

More states are contracting with managed care organizations (MCO) to provide Medicaid long-term services and supports (LTSS). How do we know if MCOs are delivering equitable, high-quality care to people receiving LTSS? Care Transitions: Individuals receiving LTSS experience smooth and safe transitions between care settings.

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Learning Intensive on State Oversight of Medicaid Managed Long-Term Services and Supports for Older Adults and Adults with Disabilities: Request for State Applications

NASHP

rebalancing spending to improve access to home and community-based services, improving care transitions, or encouraging greater care coordination) Innovative oversight approaches for Medicare/Medicaid integrated models What’s In It for States?

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State Oversight and Innovations in Medicaid-Managed Long-Term Services and Supports (MLTSS) Serving Older Adults and People with Disabilities 

NASHP

States are increasingly turning to capitated Medicaid managed care programs to deliver long-term services and supports (LTSS) to individuals with complex needs. California does cover skilled nursing facility care in its MLTSS program, but most personal care services (in-home supportive services) are provided under FFS.

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Updates and FAQs: Developing and Implementing a Medicaid State Plan Amendment to Authorize Community Health Worker Reimbursement

NASHP

CHWs are key to engagement, care coordination, and increasing access to clinical and support services for Medicaid enrollees from their communities. As such, states increasingly are pursuing Medicaid reimbursement options as part of a comprehensive CHW service financing approach, which is currently reliant on expiring grant programs.

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Supporting the Continuum of Care for Serious Illness in Medicaid Managed Care

NASHP

Supporting the Continuum of Care for Serious Illness in Medicaid Managed Care October 25, 2021 / by Salom Teshale, Kitty Purington, Wendy Fox-Grage, and Mia Antezzo. Comprehensive care coordination. billion on chronic obstructive pulmonary disease (COPD) per year. Assessment and management of pain and other symptoms.

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How State Medicaid Programs Serve Children and Youth in Foster Care

NASHP

How State Medicaid Programs Serve Children and Youth in Foster Care May 17, 2022 / Veronnica Thompson. Children and youth in foster care (CYFC) often benefit from targeted services and supports. Yet, many receive fragmented or limited access to care, contributing to higher rates of unmet health needs. [1]